Cost of Community-based Oral Fluid HIV Rapid Testing

Background: The U.S. Centers for Disease Control and Prevention recommends the expanded use of rapid HIV antibody tests in community settings to increase the proportion of persons who are aware of their HIV status. The cost of providing rapid testing services in these settings is not known.

Methods: To assess the cost of rapid HIV testing in non-profit community health provider settings we conducted a cost survey of 28 community clinics and 7 community-based organizations (CBOs). The cost analysis was conducted from the provider perspective and costs were expressed in year 2006 dollars.

Results: The mean per-client cost for HIV rapid testing was $31.65 for HIV-negative clients and $37.66 for preliminary-positive clients at the 23 clinics and 7 CBOs that did not involve physicians in rapid testing procedures; physician involvement substantially increased costs. Testing costs were higher at CBOs than at community clinics, due in part to greater personnel costs associated with pre- and post-test counseling.

Conclusions: This study provides important information about the costs of rapid testing that can be used by clinic and CBO directors to assess the economic impact of implementing rapid testing at their sites, and contributes valuable empirical data to inform discussions regarding national and local HIV testing policies.